Most carriers have similar policies about dependent coverage
for students. Generally, full-time students aged 19 and older
can retain coverage under the employee's plan, until an upper
age limit is met. The upper age limit ranges from 23-25 and
depends upon the plan and carrier. Dependents aged 19 and older
who are not full time students are eligible for continuation
under COBRA or CalCOBRA, however an individual plan may make
more financial sense.
What to do as an employer...
Remind employees to review their options if they have
dependents that are graduating from high school or college.
To remain eligible for coverage dependents must:
- be full-time students (as defined by the carrier)
- be unmarried
- be dependent upon the employee (per IRS)
- be under the age limit set by the carrier
What employees should do...
First, check their health plan's policies by reviewing their
evidence of coverage or calling member services. (This
information is also available in your plan administrator guide.)
Then,
If a dependent no longer meets the requirements for
coverage:
- The employee should complete a change form and submit it
to the employer or carrier as required.
- Review coverage options, such as COBRA, Cal- COBRA or an
individual plan.
If a dependent reaches the lower age limit, but is a
full-time student:
The carrier may request that information or proof regarding
the student's full-time status be submitted within a certain
time period.
- Some carriers will notify the employee that their
dependent is reaching the age limit and request information.
- Others carriers send a request for information after a
claim is filed.
Carriers often also require verification of student status on
an ongoing basis, annually or during each school term.
About COBRA / Cal-COBRA rights...
Employees are responsible for notifying you and/or the health
plan of changes in their dependent coverage. Dependents who lose
group coverage due to age become eligible for federal COBRA (20+
employee firms) / state CalCOBRA (2-19 employee firms). Covered
dependents of domestic partners are not eligible for federal
COBRA continuation of benefits.
Questions? Contact us!
We're happy to help you and your employees make sure that their
children have quality health coverage. Please refer any
questions to us at 800.733.8692 or
